Prolapsed stoma is when a piece of your intestine pushes out through the stoma, or opening, in your belly. It’s a possible complication of colostomy or ileostomy surgery.
A prolapsed stoma may look scary, but it’s usually nothing serious. Let your surgeon or ostomy care nurse know if it happens. They’ll get you taken care of.
Why Do Stomas Prolapse?
Stoma prolapse is one of the most common complications of ostomy surgery. Although it can happen after any type of colostomy procedure, it's more likely after a loop colostomy than an end colostomy.
During loop colostomy, the surgeon pulls a loop, or piece, of your intestine out through a hole in your belly. They cut it open and stitch it to your skin to form the stoma. If the surgeon doesn't secure the loop to the inside of your belly with staples, it can pop out through the opening. The piece of intestine can stick out a little bit or a few inches.
Doctors don't know why prolapse happens to some people but not others, but a few factors could be involved. A prolapse is more likely to affect people who:
- Are very overweight or gain weight quickly
- Have weak belly muscles (this is more common in babies)
- Have a very large opening in their belly from surgery
- Put extra pressure on their belly from coughing, sneezing, constipation, or pregnancy
What Are the Symptoms of Prolapsed Stoma?
Your stoma will be longer than usual and it could be swollen. You might only notice it when you lie down. It may disappear when you stand up. Or it might be there all the time.
Prolapse can lessen blood supply to the stoma. If this happens, it’ll turn colors like dark red, purple, or pink. It’ll also feel cool to the touch. There may be sores on its surface that look like little yellow and white patches. If a blockage forms in the stoma, poop and pee won't empty into the pouch like it should.
Is Prolapsed Stoma Serious?
A prolapsed stoma typically isn't dangerous, but it can affect the way your belly looks and make it harder to attach your pouch. It’s more serious when blood supply is cut off or the stoma is blocked and waste can't drain. If the color or temperature of your stoma changes or it doesn't work right, call your surgeon or ostomy care nurse for advice.
How Do I Treat a Prolapsed Stoma at Home?
Avoid straining, heavy lifting, and weight gain to keep it from getting worse. One way to shrink a prolapsed stoma is to lie on your back for about 20 minutes. Lying down relaxes your belly muscles and lessens pressure on the stoma.
You can also try lying on your back and using gentle pressure to push it back into position with the palm of your hand. If the stoma is swollen, fill a plastic bag with ice cubes and wrap it in a towel to make a cold compress. Hold the compress to the stoma while your pouch is on and then gently press the stoma to see if it goes back into place. Your ostomy nurse can show you how to do this safely.
Sugar may be another way to treat a prolapsed stoma. It might sound odd, but sugar pulls fluid out of the stoma, which makes it shrink. Pour a few tablespoons of granulated table sugar onto the stoma and leave it on there for 20 to 30 minutes. You’ll end up with a syrupy liquid in your pouch, but it's harmless.
Stoma tissue is very delicate and easy to injure. A prolapsed stoma can rub against the opening to the pouch and get irritated or bleed. Be careful to avoid pinching the stoma between the flange (the plastic piece that fits into the ostomy pouch) and the pouch. Wear clothes with a loose waistband and keep the waistband above or below the stoma to stop it from rubbing against your clothing. Loose, pleated, or layered fabrics can help hide the stoma.
Ask your nurse whether you should wear a stoma guard, hernia belt, or other support garment to hold the stoma in place and protect it.
You may need to switch to a bigger pouch with a larger opening. A flexible pouch might be better than a rigid one because it will expand in size. You might also need to empty your pouch more often while your stoma is swollen.
Do I Need Surgery for a Prolapsed Stoma?
You may be able to manage a prolapsed stoma with self-care. You may need repair surgery if it doesn't shrink, causes symptoms, or you can't attach the pouch to it. Surgery is a must when there is a blockage or a problem with blood supply.
This is done through one large cut or several small ones. The surgeon removes the prolapsed section of your intestine and either reattaches the stoma to your belly wall or moves it to a new place. They’ll talk to you about the risks and benefits of a stoma revision and whether it's a good option for you.
When to Call Your Doctor or Ostomy Nurse
Call your surgeon or ostomy nurse if you have a new prolapse, especially if you notice any sores or bleeding. Also call if you're having problems with the pouch or it leaks.
Get medical help right away if:
- Your stoma has turned purple, brown, black, or dark red.
- Your stoma won't stop bleeding.
- You haven't pooped into the pouch for several hours and you have nausea, belly pain, or you’re vomiting.
- Your stoma has been prolapsed for more than 1 hour and nothing you do makes it smaller.